Anxiety is a fear-based emotion that ranges in intensity from mild to severe. In our fast-paced society, anxiety is suffered at epidemic proportions, thus unfortunately it is all too common. Stress plays a significant role in the development of anxiety difficulties. But it’s widespread presence in no way diminishes the discomfort and debilitating effect anxiety may have.

     At the mild end of the spectrum, anxiety is felt as an annoying discomfort which results in being on edge with a mild inability to relax in general or situationally.  In more severe experiences anxiety can disable a person from functioning and live a normal life. Panic is a brief but negatively intense experience of anxiety that may show up as an attack or acute episode.

     In families where parents have anxiety-based conditions, the behavior patterns, thought processes and values contribute to impressing an anxiety-based self and world-view upon their children. In this way, rather than an inherited genetic condition, though a propensity for anxiety may exist, parents and families teach their children to have anxiety and model anxiety for the children by example.

     Worrying is a thought process and a cognitive habit that is present in anxiety disorders. Worry is a non-productive thought pattern that is future-oriented with a focus on bad, negative, hurtful and even catastrophic events occurring.  Parents who have anxiety may express to their children countless times “be careful” or “watch out for bad people.” Such statements repeatedly warn of dangers and contribute to anxiety “training.” Worrying is part of an unhealthy anxious pattern not just because it inflates the size or likelihood of potential future dangers, but it tends to disable the worrier in anticipation of a dangerous developments rather than truly establishing proper preparation for such occurrences.

     A link exists between angry feelings and the development of anxiety reactions. When angry feelings are habitually repressed instead of expressed, they get indirectly expressed through anxiety in its many forms. As a result, should an anger provoking incident occur, anxiety may be triggered and linger at a high level for a duration afterwards.

     Avoidance is a pattern that may contribute to the onset of anxiety, but also is a behavior pattern in those who are anxious and seek to keep the level of anxiety low. It is a negative pattern that is limiting in nature. To avoid unpleasant or threatening situations, attempting to assert control over others or situations produces secondary negative results which harms relationships and discourages growth and strengthening.

See category on anxiety

See article about challenging fear

     A variety of anxiety based disorders are identified by mental health professionals. Each varies from the other by how anxiety manifests. 

Generalized Anxiety Disorder (GAD) describes a condition in which a person experiences anxiety most all the time and and in most circumstances, though the anxiety may rise and fall based upon experiences and circumstances. Generalized Anxiety Disorder contributes to chronic discomfort and a poor quality of life with symptoms of an inability to relax, chronic worry, possible insomnia and other sleep disturbance, possible gastro-intestinal problems, possible somatic complaints such as headaches and physical pain, reduced immune system and auto-immune disorders.

Panic Disorder is a anxiety-based condition in which the afflicted person experiences occasional, repetitive or frequent episodes of extreme anxiety also called panic. For someone who has never experienced a panic attack (also sometimes called an anxiety episode or anxiety attack) an initial strong assault can feel like he or she is dying from a heat attack. It is not unusual that in reaction to this severe event the individual goes to the Emergency Department of the local hospital complaining of a heart attack. The event seems to be physical in nature though it’s source is emotional. An initial panic attack may be profound and a life-altering experience and typically a first panic attack comes “out of the blue” in a relaxed moment. Many report a first panic attack when in a store or driving.

     The symptoms of panic vary from person to person, but share features such as fearing that one is going to die, terror, a heartbeat beating out of the chest, heat in parts of the body such as sweaty palms, tingling in parts of the body, a sweaty reaction, rapid cycling of thoughts and a belief one is going crazy. Once a panic attack has been experienced, the fear persists that it will happen again, potentially in the same location or during the same activity. A pattern of avoidance of precipitating situations or conditions which fear could cause a panic attack. The fear of an attack becomes a secondary level of anxiety; both levels then feed off the other in cyclic anxiety. 

Phobias are acute fearful reactions to very specific items or situations that provoke terror. Common phobias are of spiders, snakes, flying in an airplane, being in small spaces, heights, going over bridges, driving on the highway and germs. Someone who is phobic of of an item, situation or activity will avoid exposure to it at all cost due to the anticipation of terror.  For the phobic individual, exposure to the feared subject feels like he or she will be “scared to death.” A phobia is highly irrational and as a result makes no sense to those who are not phobic, but is painfully real to those who suffer from phobias.

Health Anxiety is just as it’s name suggests, a fear of and preoccupation with health threats, such as diseases and often severe as well as terminal conditions like cancer. People who have health anxiety obsess about the possibility of illness. Hypochondria is a related condition in which the fear exceeds the worry so that the feared health threat is imagined to be real when in fact it is not.

Obsessive/Compulsive Disorder (OCD) is a disorder characterized by both obsessive thoughts and compulsive behaviors. Obsessing is a powerful cycling of thoughts which cannot be slowed, despite efforts to do so. Compulsions are similar but are about behaviors.  Compulsions are repetitive behaviors which cannot be stopped; the behavior seems to have control over the person.

     Some who live with OCD have a pattern of ritualistic behaviors, such as checking doors and windows to make sure they are locked for safety, and obsessive worries that the last checking wasn’t sufficient.  For someone with OCD may need for emotional comfort for items in their environment be ordered in a very specific way otherwise anxious distress will not cease. At its worst, OCD can be very limiting and highly distressing, such that it interferes with daily functioning.

PTSD (Post-Traumatic Stress Disorder) By experiencing an overwhelmingly frightening and/or painful experience some people are traumatized.  The word trauma gives meaning to an experience of a long-term distressing impact caused by the initial damaging event. In some cases traumatic events are of physical physical harm, such as injuries sustained in car accident, in other cases painful unexpected experiences render the traumatized individual powerless. When the negative effects of trauma linger in a person’s life in an ongoing way for months and years, the condition is call PTSD or Post-Traumatic Stress Disorder.

     Unhealed trauma shows up as low self-esteem, a susceptibility to anxiety disorders, impulsivity, substantial mood changes and likely to be emotionally “triggered” unexpectedly by a variety of daily experiences. PTSD often coincides with Generalized Anxiety, Panic Disorder and chronic worry. See article about trauma 

Perfectionism is an expression of low self-esteem with OCD traits in which a person is unrealistically, ritually and obsessively determined to achieve perfection in all efforts and activities. The perfectionist’s sense of him or herself as having worth is based upon his or her perfect success. Yet in all pursuits, despite producing excellence he or she will search in a detailed way to uncover imperfections. Upon finding them, no matter how small, will declared the efforts a failure and him or herself as a failure. Perfectionist are stuck in a negative cycle of self-imposed anxiety and dissatisfaction. See article about perfectionism

Jealousy and Insecurity at their worst can destroy a relationship or marriage. Due to a deeply held fear of loss combined with the insecurity of low self-esteem, some partners are chronically afraid they will be rejected or lose their loved one. Women worry and obsess that their beauty and desirability are insufficient, that their partner will be more attracted to another. Men fear that they are not strong enough, not sexually skilled enough, not funny enough…all symptoms of low self-esteem.

     Jealous partners are challenged with other anxiety disorders as well, Generalized Anxiety Disorder most likely. The jealous partner will express his or her insecurity through an inability to trust, chronic suspiciousness, investigating the partner and grilling the partner with questions to try and feel safe. These behaviors have the opposite of the desired effect. Rather than safety and security in the relationship, jealous partners drive the other away increasing the risk of loss or betrayal. See article about jealousy 

Performance Anxiety is an emotional trap. Once a man has experience of failed sexual performance and reacts with horror, a pattern becomes entrenched in which he worries about his performance in each subsequent sexual opportunity. Because a relaxed and positive attitude supports good sex and successful male sexual performance and fear, worry and negative feelings undermine good sexual performance, his worry contributes to a re-occurring self-fulfilling prophesy in which failed performance is worried about so failed performance occurs.

      For maintained arousal, manifested by an erection, a man must be relaxed and  undistracted to enjoy the pleasure of excited feelings in his body. If anxious, he is less likely to maintain arousal and be unaware or insensitive to physical sensations of excitement; he will lose his erection. The cycle is then repeated.  

     Men who have experienced failed sexual performance may be beset with painful feelings of inadequacy. Such men have a tendency to avoid sexual encounters. 

     Performance anxiety is an anxiety-based emotional trap that may snare anyone at anytime high pressure for high performance is in place. Whether it be a student regarding tests, an athlete regarding competitive success, a woman regarding sexual arousal, all are prone to vicious cycles of performance anxiety.

Anxiety and Love Relationships

Love and fear are opposites. When a partner in a love relationship suffers with fear-based anxiety, it directly neutralizes the quality of love shared between partners. Anxious people are afraid and defended, yet to love a partner needs to be relaxed and open. Anxious partners attempt to control their environment as a way to keep their anxiety low, but the way to love a partner is to accept him or her while accepting how the partner is.

Anxiety and Sex: the quality of a sexual experience is directly related to how relaxed are the partners. When anxious, partners are less available for connection, but also less able to become aroused, maintain arousal, less able to achieve orgasm…an anxious partner is less able to participate in a good and satisfying sexual experience.  Anxiety is detrimental to good sex.  An anxious partner, one who has experienced trauma may also be sexually inhibited, or withdrawn so they do not sexually “show up.”

Medication for Anxiety

For those with severe anxiety, medication can be helpful. Commonly anti-depressant medication is prescribed which is also effective at reducing anxiety, but with possible negative side-effects such as less sensitivity to emotions, flatter emotional experience, some cause weight gain, reduced interest in sex, and some cause inhibited or inability to achieve orgasm. Anti-anxiety medication can also be very effective at reducing the discomfort of anxiety. The risk of these medications is the possibility of addiction and must be used with restraint and care. They may also cause some sexual side effects. Andrew Aaron, LICSW